Bakker Kathleen, Catroppa Cathy, Anderson Vicki
1 Department of Paediatrics, University of Melbourne , Victoria, Australia .
2 Murdoch Childrens Research Institute , Melbourne, Australia .
J Neurotrauma. 2016 Apr 15;33(8):777-83. doi: 10.1089/neu.2015.4075. Epub 2015 Dec 14.
There is increasing evidence that disruption of olfactory function after pediatric traumatic brain injury (TBI) is common. Olfactory dysfunction (OD) has been linked to significant functional implications in areas of health, safety, and quality of life, but longitudinal research investigating olfactory recovery is limited. This study aimed to investigate recovery trajectories for olfaction following pediatric TBI and explore predictors of early and late olfactory outcomes. The olfactory function of 37 children with TBI ages 8-16 years was assessed on average at 1.5, 8.0, and 18.0 months post-injury using the University of Pennsylvania Smell Identification Test. A significant improvement in olfactory performance was seen over time in those with acute OD, however, only 16% of those with the most severe OD showed recovery to normal olfactory function, with the remainder demonstrating ongoing olfactory impairment at the 18 month follow-up. Predictors of early (0-3 month) and late (18 month) olfactory outcomes varied with site of impact, a significant predictor of later olfactory performance. In summary, while there was evidence of recovery of OD over time in pediatric TBI, the majority of children with severe OD did not show any recovery. In light of limited recovery of function for more severely affected children, the importance of appropriate education and implementation of rehabilitation management strategies is highlighted.
越来越多的证据表明,小儿创伤性脑损伤(TBI)后嗅觉功能受损很常见。嗅觉功能障碍(OD)与健康、安全和生活质量等方面的重大功能影响有关,但关于嗅觉恢复的纵向研究有限。本研究旨在调查小儿创伤性脑损伤后嗅觉的恢复轨迹,并探索早期和晚期嗅觉结果的预测因素。使用宾夕法尼亚大学嗅觉识别测试,对37名8至16岁的创伤性脑损伤儿童的嗅觉功能在受伤后平均1.5个月、8.0个月和18.0个月进行了评估。急性嗅觉功能障碍患者的嗅觉表现随时间有显著改善,然而,最严重嗅觉功能障碍患者中只有16%恢复到正常嗅觉功能,其余患者在18个月随访时仍有嗅觉障碍。早期(0 - 3个月)和晚期(18个月)嗅觉结果的预测因素因撞击部位而异,撞击部位是后期嗅觉表现的一个重要预测因素。总之,虽然有证据表明小儿创伤性脑损伤后嗅觉功能障碍会随时间恢复,但大多数严重嗅觉功能障碍儿童并未显示出任何恢复。鉴于受影响更严重的儿童功能恢复有限,强调了适当教育和实施康复管理策略的重要性。